Provider First Line Business Practice Location Address:
123 OHME GARDEN RD STE 4
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WENATCHEE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98801-4500
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
971-319-4143
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/01/2022